Doctor goes on mission of mercy

May 02, 1994|By Sherry Joe | Sherry Joe,Sun Staff Writer

In a small, dimly lighted operating room in the mountains of Ecuador, Dr. Bruce Horswell performed miracles.

During a 10-day surgical mission in March, the Ellicott City facial surgeon treated more than two dozen people for cleft lips and palates, abnormalities that require surgically closing rifts between the lips and roofs of patients' mouths.

"I knew it was going to be rough," Dr. Horswell said of his experience in the South American country. "You see the things you only see in textbooks."

Dr. Horswell, 41, was part of a 23-member medical team that included surgeons and nurses from the University of Maryland Medical Center in Baltimore who participated in Ecuadent, a program that sends health care providers to Ecuador to treat poor residents.

The Craniofacial Clinic at the UM Medical Center paid the expenses for the seven Maryland members of the surgical team. While there, the staff stayed at a military base and a hotel.

Before the trip, Dr. Horswell, who has performed craniofacial surgery at the UM Medical Center for nine months, spoke with medical colleagues who had taken similar trips to other underdeveloped nations about what to expect.

Tammy Fesche, a Westminster resident and native of Ecuador, established Ecuadent in 1991.

The program takes its name from two words: "Ecuador" and "dental."

Ms. Fesche's husband, Marshall, is a dentist, and the first trip to Ecuador included him and 16 other dental specialists.

Ms. Fesche selects program participants based on their credentials, reputation and ability to adapt to changing situations.

All volunteers pay their own air fare. The Ecuadorean army provides food, accommodations, security and transportation for Ecuadent participants.

From March 17-27, the medical team that included Dr. Horswell treated patients with facial deformities and dental problems at a health clinic in a small farming village south of Quito, Ecuador's capital and largest city with a population of slightly more than 1 million.

"The hospital conditions were very simple, with operating facilities equipped for 1950s-era surgery in the U.S.," Dr. Horswell said.

The surgeons operated on 30 children and adults with cleft lips and palates, while a team of dentists and dental assistants from Maryland and Pennsylvania screened more than 3,500 Ecuadoreans for dental problems.

On the medical crew's first day, the staff was met by more than 500 people, many with severe facial deformities that required immediate attention.

One patient Dr. Horswell met was a 5-year-old girl whose brain protruded between her eyes. The doctors did not have the time or equipment to treat the youngster in Ecuador.

Instead, they hope to bring the child and three other patients to the UM Medical Center sometime this year for treatment.

Dr. Horswell said he and a neurosurgeon will perform the operations on the patients at no cost.

But sponsors are needed to house the patients and pay their round-trip air fare.

"We'll try to find families to put them up," he said.

Some of the deformities Dr. Horswell saw were so serious the surgeons could not risk an operation without having more advanced medical equipment and facilities.

"They had jaw problems, severe burns, missing ears, eyes, noses and tumors," Dr. Horswell said.

Dr. Horswell performed six surgeries a day from 7 a.m. until 5 p.m., when the hospital closed. The operating room contained little more than a naked light bulb and a rickety table.

The surgical team operated on Ecuadoreans from 5 to 63 years old, but only those in the best of health. Infants under a year as well as those with heart and lung problems were deemed inoperable.

"We didn't accept anyone with obvious heart or lung problems because to put them to sleep would be very risky," Dr. Horswell said. The surgeons would not operate on infants because of limited post-operative care.

To ensure they had the needed medical supplies, the surgical staff brought its own supplies and personnel, including 30 trunks of equipment and medications, two nurses, an anesthesiologist, interpreter and recovery room nurse.

Ecuadorean doctors and nurses were impressed by the array of advanced medical technology, Dr. Horswell said.

"Everything we consider disposable was washed up and re-used by the nurses," said Dr. Horswell, who destroyed used syringes to prevent their re-use.

The surgical team also brought large supplies of medical instruments and medications to donate to local hospitals. Before the donation, Tylenol was the only painkiller the hospital clinic stocked.

Dr. Horswell looks forward to returning in March and would like to travel to Ecuador at least once a year.

"We took lots of names and told them we'd be back," he said. "Hopefully we will."

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